低分割三维适形放疗联合肝动脉化疗栓塞治疗中晚期原发性肝癌的疗效评价  

Hypofractionated three-dimensional conformal radiotherapy combined with trancather arterial chemoembolization for advanced hepatocellular carcinoma

作　　者：王传玺[1] 吴德华[1] 孙爱民[1] 陈龙华[1] 

机构地区：[1]南方医科大学南方医院肿瘤放射治疗科,广东广州510515

出　　处：《中华肿瘤防治杂志》2010年第4期245-248,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(30772530);广东省自然科学基金(200504776)

摘　　要：目的:评价低分割三维适形放疗(3D-CRT)联合肝动脉化疗栓塞(TACE)对中晚期肝癌综合治疗效果。方法:对确诊的110例中晚期肝癌患者随机分成两组,低分割组55例,先行TACE治疗后再行3D-CRT,6～8Gy/次,3次/周,大体肿瘤体积(GTV)剂量为48～64Gy,总周期3～4周;常规分割组55例,行TACE治疗后再行3D-CRT,1.8～2Gy/次,5次/周,GTV剂量为60～70Gy,总周期6～7周。比较两组的毒副反应和疗效。结果:低分割组CR26例,PR24例;常规分割组CR21例,PR27例。两组比较差异无统计学意义,χ2=0.485,P=0.785。低分割组1、2和3年总体生存率分别为78.2%、50.9%和25.9%,常规分割组分别为65.5%、32.7%和15.0%,χ2=4.123,P=0.042;低分割组中位生存期为27个月,常规分割组为18个月。结论:低分割3D-CRT联合TACE较常规分割明显提高中晚期肝癌的远期疗效,治疗相关毒副反应增加,但能耐受。OBJECTIVE：To evaluate the efficacy of hypofractionated three-dimensional conformal radiotherapy（3D-CRT）combined with transcatheter hepatic arterial chemoembolization（TACE）for patients with advanced hepatocellular carcinoma.METHODS：A total of 110 patients with hepatocellular carcinoma were randomized into 2 groups receiving TACE combined with hypofractionated 3D-CRT（HFR）in 3-4 weeks and with conventional fractionated 3D-CRT（CFR）in 6-7 weeks respectively.3D-CRT was delivered in 48 to 64 Gy at 6 to 8 Gy per frations for HRF or once-daily frations of 1.8 to 2 Gy to 60 to 70 Gy for CFR.RESULTS：There were 26 CR and 24 PR in the HFR group,and 21CR and 27 PR in the CFR group（χ2=0.485,P=0.785）.The 1-,2-,and 3-year survival rates were 78.2%,50.9% and 25.9% in the HFR group and 65.5%,32.7% and 15.0% in the HFR group,respectively（χ2=4.123,P=0.042）.The median overall survival duration was 27 months in the HFR group and 18 months in the HFR group,respectively.CONCLUSION：HFR group achieve better 1-,2-,and 3-year survival rates than HFR group and it increases the side which can be tolerated.

关 键 词：肝肿瘤/放射疗法 放射疗法 适形 化学栓塞 治疗性 

分 类 号：R735.7[医药卫生—肿瘤]